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Minerva Anestesiologica 2011 October;77(10):1003-10


language: English

Italian intersociety consensus statement on antithrombotic prophylaxis in hip and knee replacement and in femoral neck fracture surgery

Della Rocca G. 1, Biggi F. 2, Grossi P. 3, Imberti D. 4, Landolfi R. 5, Palareti G. 6, Randelli F. 7, Prisco D. 8

1 Department of Anesthesia and Intensive Care Medicine, University of Udine, Udine, Italy; 2 Orthopaedic and Trauma Department, Belluno Hospital, Belluno, Italy; 3 Regional Anaesthesia and Pain Therapy Department, IRCCS Policlinico San Donato, S. Donato Milanese, Milan, Italy; 4 Internal Medicine Department, University Hospital of Ferrara, Ferrara, Italy; 5 Department of Internal Medicine, La Cattolica University, Rome, Italy; 6 Unit of Angiology and Coagulation Disease, University of Bologna, Bologna, Italy; 7 Division Hip Department, IRCCS Policlinico San Donato, S. Donato Milanese, Milan, Italy; 8 Department of Medical and Surgical Critical Care, University of Florence and Unit of Atherothrombotic Disease, Careggi University Hospital, Florence, Italy


Anticoagulant prophylaxis for preventing venous thrombembolism (VTE) is a worldwide established procedure in hip (HR) and knee replacement (KR) surgery, as well as in the treatment of femoral neck fractures (FNF). Different guidelines are available in the literature, with quite different recommendations. None of them is a multidisciplinary effort as the one presented. The Italian Society for Studies on Hemostasis and Thrombosis, the Italian Society of Orthopedics and Traumatology, the association of Orthopedic Traumatology of Italian Hospitals, together with the Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care have set down easy and quick suggestions for VTE prophylaxis in HR and KR surgery as well as in FNF treatment. This inter-society consensus statement aims at simplifying the grading system reported in the literature, and thus at improving its proper application.
Special focus is given to fragile patients, those with high bleeding risk, and on those receiving chronic antiplatelet and vitamin K antagonists treatment. A special chapter is dedicated to regional anesthesia and VTE prophylaxis.

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